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Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results: Etiology of stricture is shifting from infective to in inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions: Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising. [ABSTRACT FROM AUTHOR]

Introduction: Leiomyosarcoma of prostate is rare accounting for 0.1% of prostatic malignancies. We report three cases of lieomyosarcoma of the prostate which were managed with surgery and postoperative radiotherapy and chemotherapy. Materials and Methods: Two patient presented to us with severe obstructive LUTS and palpable suprapubic mass. Third patient presented to us with an SPC in situ which was put in a private hospital for AUR. One patient had bilateral lung nodule on CT chest. CT guided FNAC from this lesion did not reveal any malignant cells. Preoperative trucut biopsy revealed SMA positive lieomyosarcoma in all the three patients. Two patient underwent cysto prostactomy with ileal conduit formation with no gross residual disease and the third patient underwent excision of the mass which was arising from prostatic capsule. Post operatively the patient received EBRT 50 Gy followed by chemotherapy (vincristine, adriamycin and cyclophosphamide). One patient had to discontinue RT for 15 days because of UTI. All the three patients have now more than 6 months follow up with no recurrence on follow up CT scan. Conclusion: Contemporary data on prostatic sarcoma is limited Surgery has been the mainstay in treatment and usually involves cystoprostatectomy. The rare occurrence of adult prostate sarcoma has limited the critical evaluation of treatment strategies and patient survival is restricted to anecdotal experience. In our cases we could achieve complete resection with no metastasis and patient had good response to radio and chemotherapy. So we conclude that combined modality of therapy is the best approach for these rare tumor. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the results and complications of percutaneous nephrolithotomies performed in kidneys located at abnormal site. Materials and Methods: Records of patients with stone in anomalous kidneys undergoing PNL were reviewed and analysed for the outcome and procedure related complications. Results: There were 12 patients: 11 Horse shoe kidney and 1pelvic kidney patients who underwent PNL. The mean age was years 35 (13-65 years). Two patients were women. The bilateral simultaneous procedure was done in 1 case. Laparoscopic assisted PNL was performed in 2 cases: one for pelvic kidney and other for horse shoe kidney with calculus. There was open conversion in one case. In 8 patients superior calyceal puncture (either supracostal or subcostal triangulation technique) was enough for stone retrieval while in 2 patients multiple punctures were needed. There were residual calculi in 4 cases. One patient with residual calculus in horse shoe kidney was taken up for relook PNL. In the remaining three with residual calculi no further treatment was given. One case of horse shoe kidney had colonic injury which was diagnosed postoperatively and was managed conservatively by pulling the nephrostomy tube and converting it into colostomy. The laparoscopy assisted PNLs had prolonged drainage which resolved on conservative management. Conclusion: PNL is feasible in abnormally located kidneys. The preoperative imaging including CT scan helps in planning and avoiding the potential complications like colonic injury. Laparoscopy is helpful in retracting the bowel to avoid injury during PNL. [ABSTRACT FROM AUTHOR]